WRITTEN QUESTION No. 3038/98 by Astrid THORS to the Commission. Spread of resistant MDR-TB in Russia
Date: 1998-10-08
Institutions: European Parliament, THORS
Subjects: EU financing, Russia, World Health Organisation, in-service training, infectious disease, paramedical profession, penal institution, penitentiary staff, public health













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91998E3038

WRITTEN QUESTION No. 3038/98 by Astrid THORS to the Commission. Spread of resistant MDR-TB in Russia  


Official Journal C 135 , 14/05/1999 P. 0157 





WRITTEN QUESTION E-3038/98by Astrid Thors (ELDR) to the Commission(8 October 1998)Subject: Spread of resistant MDR-TB in RussiaAccording to the Guardian (23.9.1998), a mutant form of tuberculosis called multi-drug resistant TB-MDR-TB is spreading quickly in Russian prisons. Ordinary TB in Russia can be treated in six to eight months, MDR-TB takes 18 months to treat and there is only a 60-85 % chance of survival. Furthermore, the treatment of MDR-TB is very expensive compared to the treatment of traditional TB. MDR-TB is spreading quickly in overcrowded Russian prisons and is passed on into the rest of society as prisoners are freed and through prison personnel. Obviously MDR-TB knows no national borders. Tackling the crisis is going to prove very expensive even according to modest estimates.What is the Commission going to do to help Russia stop the spread of MDR-TB and thus combat a major threat to Russia, Europe and the rest of the world?Answer given by Mrs Bonino on behalf of the Commission(16 November 1998)The Commission shares the concern of the Honourable Member about the dramatic increase in tuberculosis (TB) cases in the Community of Independent States (CIS) in the 1990s. In the Russian Federation, the case rate rose by 42 % between 1991 and 1994. In the period 1995-1996, a further increase by 4 % was observed. By 1996, tuberculosis had become the most important lethal infectious disease in the country.The World health organisation (WHO) advocates DOTS (directly observed therapy short course) a relatively cheap and effective scheme of curing TB patients and preventing transmission, but this has unfortunately proved difficult to implement in the Russian Federation due to lack of drugs and the fact that treatment preferences vary among local medical staff. Treatment methods are often changed during a cure, favouring the increasing appearance of drug resistant bacteria.Throughout the last year, the Commission has been funding specific humanitarian projects addressing this problem (DOTS training for local medical staff, provision of drugs). These activities have been focusing on prisons in Central Siberia, where the TB issue is particularly important.While it is understood that the scientific aspects of TB, including the potential adaptation of existing treatment methods to multiple-drug resistant bacteria, have to be addressed by specialised agencies such as WHO, the Commission is considering the continuation and possible expansion of its programmes in the Russian Federation.However, it has to be stressed that the medium-term success of these efforts will depend on effective implementation of the recommended treatment strategies by local medical authorities.